摘要
背景:重组人骨形态发生蛋白2和重组人骨形态发生蛋白7治疗骨缺损已经应用于多种实验动物模型。作者前期实验在兔自体髂骨与骨痂骨等长骨骨折治疗中应用,已取得满意效果。目的:验证采用骨折断端周围晚期自体骨痂复合重组人骨形态发生蛋白2移植治疗骨缺损效果,并观察血管内皮生长因子对骨折愈合的影响。设计、时间及地点:随机对照实验,于2008-08/2009-01在本溪市中心医院科研实验室和中国医科大学附属二院实验动物中心完成。材料:2.0～2.5kg的成年健康日本大耳白兔20只。方法:将兔行双侧桡骨中段模拟骨折,12周后观察至明显骨痂生长随机分配实验Ⅰ组10只,实验Ⅱ组10只。在原骨折部位手术,切除骨痂备用,同时切除骨折端使之缺损1.5cm,实验Ⅰ组,左桡骨移植复合重组人骨形态发生蛋白2骨痂为为骨形态发生蛋白2骨痂组,右桡骨移植髂骨为移植自体髂骨组,实验Ⅱ组,左桡骨移植晚期自体骨痂为移植晚期自体骨痂组,右桡骨空白对照为空白对照组。主要观察指标:于术后14d取标本检测各组兔血管内皮生长因子基因mRNA表达水平的。结果:骨形态发生蛋白2骨痂组、移植髂骨组的血管内皮生长因子mRNA及蛋白表达水平差异无显著性意义(P>0.05);移植晚期自体骨痂组、空白对照组血管内皮生长因子未见明显表达。骨形态发生蛋白2骨痂组、移植髂骨组的血管内皮生长因子蛋白表达及基因表达明显高于移植晚期自体骨痂组、空白对照组(P<0.05)。结论:骨折断端周围晚期自体骨痂复合重组人骨形态发生蛋白2明显促进血管内皮生长因子的合成分泌,对促进骨缺损愈合有积极意义。
BACKGROUND： Recombinant human bone morphogenetic protein 2 （rhBMP-2） and recombinant human bone morphogenetic protein 7 （rhBMP-7） for treatment of bone defect have been used in many experimental animal models. The prophase experiment was performed with long bone fractures such as rabbit ilium and callus, and showed satisfactory results.
OBJECTIVE： To validate the effect of rhBMP-2 on treating nonunion of late-stage callus around fracture site, and to investigate the expression of vascular endothelial growth factor （VEGF） in the callus and its influence on fracture healing.
DESIGN, TIME AND SETTING： The randomized controlled experiment was performed in Research Laboratory of Benxi Central Hospital and Laboratory Animal Center of The Second Affiliated Hospital of China Medical University from August 2008 to January 2009.
MATERIALS： Twenty healthy adult Japanese big ear rabbits weighing 2 to 2.5 kg.
METHODS： Bilateral radial fractures were created in rabbits. Twelve weeks after previous operation, all animals showed obvious osteotylus forming at the fractured site. The rabbits were randomly assigned into group Ⅰ （10 rabbits） and group Ⅱ （10 rabbits）. Osteotylus was excised and a 1.5 cm bone defect was created. In group Ⅰ, the transplantation of rhBMP-2 and osteotylus was operated in the left radius as transplantation composite rhBMP-2 osteotylus group, and transplantation of the ilium in the right radius was operated as ilium group. In group Ⅱ, the transplantation of osteotylus in the left radius was operated as osteotylus group, and blank control of the right radius was set for control group.
MAIN OUTCOME MEASURES： Fourteen days after transplantation, mRNA expression of VEGF was detected in different groups.
RESULTS： In transplantation composite rhBMP-2 osteotylus group and ilium group, there was no significant difference in the expression of mRNA and protein of VEGF （P 〉 0.05）. There was a small amount of expression of mRNA and protein of VEGF in osteotylus and control groups. In transplantation composite rhBMP-2 osteotylus group and ilium group, the expression of mRNA and protein of VEGF was higher than that in osteotylus and control groups （P 〈 0.05）.
CONCLUSION： Transplantation of osteotylus around fracture site with recombinant rhBMP-2 accelerates the secretion of VEGF and fracture healing. This plays an important role in fracture healing.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第41期8030-8034,共5页
Journal of Clinical Rehabilitative Tissue Engineering Research
